Job Summary
A company is looking for an RN Utilization Management (Relief).
Key Responsibilities
- Conducts concurrent and retrospective utilization management reviews to ensure medical necessity and appropriate patient status
- Collaborates with interdisciplinary teams, physicians, and payors to address medical necessity and status concerns
- Monitors and reports on the effectiveness of the utilization management program, implementing process improvements as needed
Required Qualifications
- Graduate of an accredited school of nursing
- Current Oregon RN license
- Three years of acute care clinical nursing experience
- Two years of utilization management experience or equivalent professional experience
- Experience working with electronic health records
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